Insurance policy



M'mh 10, 1925. 1,529,383

J. W. WHITUS INSURANCE POLICY Filed 1922 '3 Sheets-Sheet 1 Z HE THRIE' 7 /F f JVMW. 1e. Paez 7 7 THE CON TRACT The Cash Value m. MA A-" n... Nam. s 1 Jwwmtoz fi st 'pm mun (Asa LOANSs- On demand which W1.

AW 7 Q Kw flttmmg:

March 10, 1925. 1,529,383

J. W. WHITUS INSURANCE POLICY Filed Aug. 21. 1922 3 Sheets-Sheet '2 x m x I Pn 'e 3.

4 I a 5 a new am; i910 1140 uau \sna nova [15w m use i5 332 ZPaid up Policy for $100 of l-nsuranceon theZO-Rzyment Life Plan.

For "4- dam-1 and: a Mr... (L i x m-i 5.4.: 3 4 19 Yflr: Vans 0 8:0 104 1550 use W'asu limo 4660 no 510 lam me 1:50 "a no 5:70 am n I Q52 55 920 "do rllAnm Th! msi -ended'surnce a EXTENDED msuemcfi. taxman? m 17 m M M a a 3 1 40 P; l-

5203950 1 6J7471Ia58 waa9 710010 lounbrzslae V Zlwventoz March 10, 1925.

J. w. WHITUS msunmcs POLICY Filed Aug. 21. 1922 3 Sheets-Sheet 5 17.2%.

,/ NUMBER- Patented l fter. id, 11925.

INSURANCE PQL'JLICWZ.

Application filed August 21, 1922. Serial No. 583,313.

blank forms and more especially to insurance policies and similar forms, and the primary object of the present invention is to simplify the issuance of insurance policies and the collection of premiums thereon.

More specifically, it is the primary object of the invention to provide what may be considered as a blanket or omnibus insurance policy capable of embracing any desired number of insured and which number at any period in the life of the policy may be increased or decreased, in the first instance through the extension of the policy to additional insured and in the second instance by the lapse of the insurance so far as it relates to any of the insured either by reason of death or for other reasons. Thus by providing for the extension of the terms of the policy to any desired number of insured, the expense and labor involved in issuing and keeping the records of an equivalent number of policies is saved or avoided and the overhead expense is reduced to such a figure as to recommend the policy to any company operating under any system whatsoever.

In the accompanying drawings:

Figure 1 is a plan view of a policy form embodying the invention;

Fig. 2 is a similar view of a fragmentary nature illustrating the character of the matter contained on the second page or inside cover of the form;

Fig. 3 is a similar view illustrating matter contained on page 3;

Fig. 4 is a similar view illustrating one face of a record card which is employed as an adjunct to the form shown in Fig. 1;

Fig. 5 is a similar view of the other face of the said card.

The policy form shown in Figs. 1, 2 and 3 of the drawings may embody any suitable number of pages and in the illustrated embodiment of the invention the first or cover page of the policy, which is indicated by the numeral 1, bears a suitable title as indicated the by the numeral 2, a spacer3 for the policy ample, may embody an infantile table 5'forages'up to ten years. In a, column headed by a suitable- Policy No. and indicated by the-numeral 6, is written the policy number. opposite and to the left of the name of eachinsured, the names of the insured being written "in a column 7 provided for that purpose. Ina column 8 located between the'columns 6. and 7, are written, in alphabetical order, the letters of the alphabet which inconjunction with the eneral policy number appearing opposite them in thecolumn 6-suitably identify the different parties insure-d. In another column indicated by the numeral 9 may be written the age of each of the insured, and in a column'10 at the right of the column 9 may be written the maximum.

amount of insurance as regards each of the holders of the policy. Other columns ll, 12 and 13 are provlded at the right of the column for the entry, respectively, of theannual, semi-annual, and quarterly, monthly or weekly premiums on the insurance of each of the. holders. Another column 14 is provided at the right of the quarterly premium column 13 for the entry of the'dateon which the terms of the policy were extended to each of the individuals insured thereunder. The amounts listed in the column- 10 and any one or more of the columns. 11, 12 and 13, may be totaled at the bottoms of the respective columns so that if, for example, the premiums are to be paid semi-annually, the total amount due on all of the insured will appear at the bottom of the column 12. Figure 2 of the. drawings illustrates a portion of the second page of the policy and on this page may be printed the contractor conditions under which the policy is issued.

Page 3 of the policy is illustrated in a general way in Fig. 3 of the drawings and this page bears any suitable number and arrangement of tables as, for example, a table 15 representing the cash surrender and loan valuesfor a stated amount of insurance on a twenty payment life plan; a table 16 setting forth the amount of paid up policy for a stated amount of insurance at the end legend such, for example as of stated periods; and, a table 17 the periods of extended insurance after the policy has been in force stated periods of years.

As an adjunct to each policy there are provided two cards which are precise duplicates and one of which is illustrated in a general way in Figs. 4 and 5 of the drawings. Upon one face of the card there are provided columns 6 7 8 9", 10,.11, 12 13 and 14* corresponding to the columns 6 to 14, inclusive, upon the face of the policy as heretofore described and in which columns the same entries are to be made as in the columns of the policy. This face of the card also bears a ruled space 18 for the entry of the number of the policy. Also this face of the card bearssuitably designated lines 19 for the entry of the name and address of the principal holder of the policy or the one who is to be looked to for the'payment of the premiums. Also this face of the card bears a space 20 in which may beset forth the plan under which the policy is issued. The opposite face of the card, as shown in Fig. 5, bears columns 21, 22 and 28 in which may be entered respectively, the date on which payments are due, the amount paid, and the date of the last payment made. This face of the card bears another column 24 in which may be entered data relating to the lapsing of the policy as regards anyone of the insured, through death or otherwise. Adjacent the column 24 there is provided a column 25 in which may be entered data relating to the revival of the insured.

From the foregoing description it will be evident that by carrying out the invention, a single policy may be made to embrace any desired number of insured and that by car rying out this plan the various transactions may be performed in much less time and with much less labor than would be involved if separate policies were issued as is now customary. Also an enormous saving in the cost of printing is effected.

Having thus described the invention, what is claimed as new is:

1. An insurance policy having a column of spaces designated for the entry of a policy number, and letters associated with the spaces, the policy having other columns of spaces designated for the entry of the names of the insured whereby respective names will be identified with certain letters, and spaces designated for the entry of the premiums on each of the insured.

2. An insurance policy having a column of spaces designated for the entry of a policy number, and letters associated with the spaces, the policy having columns of other spaces designated for the entry of the names of the insured whereby each name will be identified by a letter, spaces for the entry of the maximum amount of insurance on each holder, and other spaces designated for the entry of premiums on each of said entered maximum amounts.

3. An insurance policy having a space in-- dicated for the entry of and a column of other spaces designated for the entry of the same policy number, the policy bearing letters associated with the last-mentioned spaces whereby each of a plu rality of persons insured may be identified by the policy number and do letter, the policy having other spaces'in a column designated for the entry of the names of the insured a'lined with the spaces bearing the said letters, and still other spaces in a column designated for the entry of the premiums due on the amount of insurance of each of the named parties.

at. An insurance policy'having a space in dicated for the entry of a policy number and a column of other spaces designated for the entry of the same policy number, the policy bearing letters associated with the last-mentioned spaces whereby each of a plurality of persons insured may be identified by the same policy number and an associated index letter, the policy having other columns of spaces designated for the entry of the names of the insured in spaces alined with the spaces bearing the said letters, and other columns of spaces designated for the entry of the premiums due on the amount of insurance of each of the named parties, the

last-mentioned spaces being arranged in a plurality of series designated by legends in-v dicating different periods of time when premiums are to be paid.

5. An insurance policy having a space indicated for the entry of a policy number and a column of other spaces designated for the entry of the same policy number, the policy bearing letters associated with the last-mentioned spaces whereby each of a plit rality of persons insured may be identified by the policy number and an associated in dex letter, the policy having other columns of spaces designated for the entry of the names of the insured opposite the spaces bearing the said letters, and still other columns of spaces designated for the entry of the premiums due on the amount of insurance of each of the named parties, the lastunentioned spaces being arranged in a plurality of series designated by legends indicating different periods of time when premiums are to be paid, in combination with a record card having a substantially corresponding arrangement of designated spaces. In testimony whereof I afiix my s1gnature.

JAMES WHITUS. [1,. s]

a policy number an associated inf 

